New study puts Puerto Rico's hurricane deaths in the thousands

A man in San Juan, Puerto Rico, places a pair of sandles in front of the capitol building to represent those killed by Hurricane Maria. THAIS LLORCA | EPA VIA CNS

WASHINGTON — Few believed the initial official figures that said
64 people died in Puerto Rico as a result of Hurricane Maria in September 2017,
a stunningly low statistic that officials released shortly after what is
considered one of the island's worst natural disasters on record.

After many disputed the official number, Puerto Rican officials
commissioned a study from George Washington University in Washington to get a
more accurate number of deaths, and when its results were released on Aug. 28,
it confirmed what many had suspected: An estimated 2,975 people lost their
lives because of the natural disaster. As a result, Puerto Rico has now revised
the official death toll.

The study, carried out by the university's Milken Institute
School of Public Health, said death certificates may not have reflected
conditions caused by the hurricane that lead to fatalities in the days and
months following the disaster.

Lack of electricity and water and a general pounding of the
island-nation's infrastructure by the storm made it difficult for hospitals and
health care professionals to care for those who were struggling to recover in
the aftermath of the disaster. Death certificates may not have taken into
account all those factors and how the fatalities were a result of the
conditions created by the hurricane. In a statement, those who conducted the
study said that "lack of communication, well established guidelines and
lack of training for physicians on how to certify deaths in disasters, resulted
in a limited number of deaths being identified as hurricane related."

"Certain groups — those in lower income areas and the
elderly — faced the highest risk," said Dr. Carlos Santos-Burgoa, the
principal investigator of the project and a professor at George Washington
University, in a statement released by the university.

The study looked at excess deaths from September 2017 to February
2018 and found "a number that is 22 percent higher than the number of
deaths that would have been expected during that period in a year without the
storm," the statement said. People living in the poorest municipalities
faced a 60 percent higher than expected risk of dying during that time period,
the study said.

After the hurricane, Catholics groups and organizations from the
mainland U.S., including Catholic Extension, Catholic Relief Services, as well
as many parish groups, traveled to the U.S. territory with supplies and other
forms of aid.

The study released in August is not the first one that looked for
a more accurate number of fatalities or what may have led to the lower
statistics initially reported.

In late May, scientists from the Harvard T.H. Chan School of
Public Health and other institutions, published in The
New England Journal of Medicine a study they had conducted that said an
estimated 4,600 people died on the island because of the hurricane that slammed
into Puerto Rico with winds of 175 miles per hour on Sept. 20, 2017.

Taking into account deaths caused by flying debris, unsafe or
unhealthy conditions resulting in injury, illness or loss of necessary medical
services due to the natural catastrophe, a survey of 1,000 people that was
conducted from Sept. 20 through Dec. 31, 2017, estimated "a total of 4645
excess deaths," if compared with the same period during the previous year,
the Harvard study said.

"The figures in the study are not surprising," said Archbishop
Roberto Gonzalez Nieves of San Juan in May, when the Harvard report was
released.

Puerto Ricans have the understanding "that there are many
more who lost their lives" because of Hurricane Maria, not just as it hit
the island but also in its aftermath, he said.